Cover Image

Bridging the policy-implementation gap in federal health systems: lessons from the Nigerian experience

Andrew Mckenzie, Emmanuel Sokpo, Alastair Ager
  • Andrew Mckenzie
    Health Partners International, Cape Town, South Africa
  • Emmanuel Sokpo
    Health Partners International, Abuja, Nigeria
  • Alastair Ager
    Mailman School of Public Health, Columbia University, New York, NY, United States |


The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels of government: federal, state and local. The paper suggests that understandings informed by complexity theory and complex adaptive systems have been helpful in shaping policy and programme design across these levels. To illustrate this, three initiatives are explored: Bringing PHC under one roof, enhancing access to funding provided by the Global Alliance for Vaccines and Immunization, and strengthening the midwives service scheme. These initiatives have demonstrated how concepts and experience developed at subnational level can influence national policy and practice, and how work at subnational levels can add value to nationally conceived and nationally driven plans for PHC.


primary health care, health system, health policy, maternal health, complexity theory, drivers of change.

Full Text:

Submitted: 2013-11-23 07:26:42
Published: 2014-11-14 15:56:06
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:


Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Copyright (c) 2014 Andrew Mckenzie, Emmanuel Sokpo, Alastair Ager

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
© PAGEPress 2008-2018     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185